Aetiology of Rebound Hypoglycaemia Rebound reactive hypoglycaemia is often secondary to some underlying physical cause. It is common in patients with insulinomas and other varieties of fasting hypoglycaemia, and may be the only symptomatic feature of the autoimmune insulin syndrome (AIS). Contrary to former belief, reactive hypoglycaemia is not a common premonitory symptom of noninsulin-dependent diabetes. In practice, the most common cause is rapid gastric emptying, usually as a result of gastroduodenal surgery, but occasionally no pathoanatomical cause can be found.