Self-managing chronic conditions typically involves a diverse network of individuals and devices, forming a self-management ecosystem. For this ecosystem to be effective, components need to work together cohesively. The rapid advancement of technology means new devices need to be repeatedly integrated into existing self-management ecosystems. To examine this process, we used the case study of young adults with type 1 diabetes (T1D) in the UK who were given a smartwatch. Over six months, interviews and focus groups were performed to explore their smartwatch use alongside T1D management. Thematic analysis highlighted that smartwatches have potential as a display, interface and data source in T1D management, which is of particular importance as artificial intelligence plays a growing role in self-management ecosystems. It also emphasised the need for customisation, flexibility and adaptability, and automation in the design of technology to promote integration into existing self-management ecosystems for both T1D and other chronic conditions.

Self-managing a chronic condition involves adapting management strategies to life’s continual change. Among these changes, moments of significant life transition can render routine self-management practices obsolete without significant modification to the new context. In this study, we examine one significant life transition for young adults living with Type 1 Diabetes, the move from home to university, to understand how near future AI-enhanced technologies might provide opportunities and challenges for supporting care. From interviews with 24 students in the UK who had moved away from their childhood homes, we used sensemaking literature to frame the process of initial disruption to the rebuilding of self-care practices around a new lifestyle and support networks. By studying a significant life transition, we uncover implications for the design of T1D technology, particularly closed-loop systems, through AI enhancements and human-centred design approaches, then extrapolate for other significant life transitions and chronic conditions.