D2 just likes to hog CPU from what I've seen, particularly in older patches. In those older patches you want to set the process affinity to just use a single processor (crucial with multi-instance). This can be done in task manager. I don't think glide wrapper has anything to do with it. But if it does, then it is probably better to just use the 1.14 wrapper provided by blizz, though I don't think it supports captured mouse.
The settings look just fine to me, but I'm not an expert. I'm not aware of any NVidia specific settings. Unfortunately can't cross-reference my own settings for a week as I'm away from my desktop.