Susan Littlehorse (28 years old, obese, and pregnant) complains of burning urine

She seems to have gestational diabetes. You will need to perform a glucose challenge test to confirm your initial diagnosis. You should suggest to her that she begin a healthier life style: a better diet and regular exercise. If the condition is not resolved, then you may need to prescribe insulin or other medications.
There is risk to Susan of developing preeclampsia during pregnancy and of having a baby with excessive birth weight, which could lead to a difficult delivery or a cesarean section. Furthermore, Susan may subsequently develop type 2 diabetes.