Despite advances in public health and medical treatment, the number of patients with type 2 diabetes is increasing and it remains among the top 10 causes of death and a leading cause of disability in the United States. Early interventions with innovative approaches are essential to improving dietary intake and blood glucose control, potentially preventing or delaying type 2 diabetes and related complications. This study examined the effects of integrating real-time feedback from continuous glucose monitoring (CGM) into individualized nutrition therapy (INT) on diet and sleep quality in individuals with prediabetes and overweight or obesity. Thirty participants were randomized to either the treatment ( = 15) or the control group ( = 15). Both groups received individualized nutrition recommendations tailored to energy needs for weight maintenance and blood glucose control. The treatment group had real-time access to CGM data, while the control group remained blinded. Dietary intake and sleep quality were assessed using ASA24 recall and analyzed via general linear model repeated measures. Incorporating CGM feedback into nutrition therapy significantly increased whole-grain ( = 0.02) and plant-based protein intake ( = 0.02) in the treatment group, with trends toward increased fruit intake ( = 0.07) and a reduced percentage of calories from carbohydrates ( = 0.08). Sleep efficiency also improved significantly by 5% ( = 0.02) following the intervention. These findings support the effectiveness of CGM-enhanced nutrition therapy in improving diet and sleep quality in individuals with prediabetes and overweight or obesity. Further research is needed to assess the sustainability and long-term impact of this approach.