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A 58 year old woman presents to her general practitioner with concerns about osteoporosis. Her mother recently received this diagnosis after a hip fracture. She herself has never had a fracture. She has type 2 diabetes and hyperlipidaemia, and takes metformin, linagliptin, and atorvastatin. She does not smoke or drink alcohol. She reports reaching menopause at the age of 50 years. You arrange a dual-energy x ray absorptiometry (DXA) scan, which shows T-scores of −1.4 and −2.1 standard deviations in her lumbar spine and femoral neck, respectively.