METHODS: This retrospective observational cohort study included 236 patients (bariatric surgery, n = 115; medical therapy, n = 121) with obesity and T2DM managed at Hospital Canselor Tuanku Muhriz (HCTM), Universiti Kebangsaan Malaysia, between 2016 and 2020, with follow-up for up to five years. Direct diabetic medication costs were derived from institutional pharmacy acquisition pricing and compared annually. Diabetes remission was defined according to American Diabetes Association criteria. Multivariable logistic regression was performed to identify independent predictors of remission. Multicollinearity among correlated predictors was assessed using variance inflation factors (VIF).