Grade 3 Fatty Liver, Hb1Ac 6. 6 EGA 143.

BilYpsa (saroglitazar 4 mg) can reduce liver fat and improve lipids and HbA1c while you take it, but its benefits are not permanent after stopping unless lifestyle changes are sustained; it is not a cure and glucose may drift up again if weight, diet, and activity are not maintained. Continue weight reduction to a healthy waist and BMI; recheck HbA1c, fasting glucose, lipid panel, ALT/AST, and elastography/CAP in 3–6 months to gauge response. If triglycerides remain high or liver fat/fibrosis remains severe, a finite course of saroglitazar with monitoring can be reasonable; stopping later should be paired with strict lifestyle to preserve gains, and therapy decisions should be individualized with your hepatologist/endocrinologist.