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Gently massage in upward circular motions

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Restivo I, Attanzio A, Tesoriere L, Allegra M, Garcia-Llatas G, Cilla A

however, if you are very thin or concerned about injecting into muscle, gently pinch a fold of skin between thumb and forefinger Insert the needle : Hold the pen at a 90-degree angle to the skin surface and insert the needle fully with a swift, smooth motion Inject the medication : Press the dose button completely and hold for 6 seconds (count slowly: "one-thousand-one, one-thousand-two..." up to six) to ensure full dose delivery Withdraw the needle : Remove the needle at the same angle it was inserted, release the skin pinch if used, and dispose of the needle safely in a sharps container Common technique errors that increase lump formation include: Injecting too rapidly without the 6-second hold, causing medication to leak back out Incorrect angle (too shallow or into muscle rather than subcutaneous tissue) Injecting into lipohypertrophic areas , which impairs absorption and perpetuates tissue changes Reusing needles , which become blunted and cause increased tissue trauma Note that upper-arm injections may require assistance from another person