Hello,
Yes, you absolutely MUST start making some dietary changes as well as hopefully increasing exercise. We have research that shows even small amounts of weight loss(5-10 pounds) will decrease glucose levels, as well as help high blood pressure. Your current glucose ranges are too high and definitely need treatment to avoid complications from diabetes.
Januvia is a good medication, although it may not be enough to bring your glucose levels under good control given that your A1C is so high. Insulin is one of the options and it is a good one because it works. Using needles is not something people prefer, but if it makes you healthy in the long run it is much better than the alternative Still, there are many other medications that can be taken by mouth besides Januvia, so you may not need insulin just yet.
Be sure to give dietary changes and exercise a good try and stick with those changes. Keep checking blood sugars regularly. Drink lots of water, cut out all sodas and juices. Stay in close contact with your doctor so that your regimen can be changed if necessary.
Take care.
Forgot to tell im 33 years