You need to contact your PCP.

No but let your physician know that you are having high bedtime sugar

If you have never had high blood sugars in the past, you need to see your primary care doctor immediately. Random blood sugars > 200 indicates you are probably Diabetic.

That depends on what type of diabetes you have & how you feel. If you have Type 2 diabetes & are taking oral agents, the answer is No. You do need to see a diabetes Dr. though & get your medication adjusted to get the blood sugar down. If you have Type 1 diabetes, the answer is probably yes since ketoacidosis may be starting. If you are not sick & BS that high & you are taking insulin, you can treat this at home by taking some supplementary doses of short acting insulin. If this is a chronic problem (that way all the time) you need to see your doctor since BS this high & sustained will lead to complications such as loss of vision, kidney failure, heart attacks & stroke and foot ulcers & amputations. Occasional high BS from overeating or eating too much carbohydrate will occur in all of us & needs only take a little extra medication or MORE IMPORTANT follow the dietary rules.