Perioperative hyperglycemia is a known risk factor for surgical site infections, delayed wound healing, and increased morbidity and mortality, yet adherence to intraoperative glucose monitoring remains low despite established guidelines. This quality improvement project aimed to determine whether implementing a Clinical Decision Support Tool (CDST) in the electronic medical record (EMR) would improve compliance with intraoperative glucose monitoring and reduce perioperative hyper- and hypoglycemia among adults with type 2 diabetes mellitus undergoing elective noncardiac surgeries lasting at least two hours. Conducted at two community hospitals in Southern California, the project followed the Iowa Model of Evidence-Based Practice and utilized a quantitative design, including retrospective and post-intervention chart audits over a three-month pre- and three-month post-implementation period. The CDST generated automated intraoperative prompts for glucose testing at recommended intervals. Data were analyzed using descriptive statistics, independent samples t-tests, Mann-Whitney U tests, and Chi-square tests, with significance set at p < .05. Results demonstrated a significant improvement in intraoperative glucose monitoring compliance following CDST implementation (χ² = 7.10, p = .008). However, there were no significant differences in mean preoperative or postoperative blood glucose levels between pre- and post-implementation groups, nor in rates of intraoperative hyperglycemia. While improvements in glycemic control were not statistically significant, the CDST successfully enhanced provider compliance and embedded evidence-based monitoring into perioperative workflows. These outcomes underscore the potential of digital decision support systems to strengthen safety culture, standardize practice, and serve as a foundation for future system-wide optimization of perioperative glycemic management.