Short-term effects of alcohol consumption include intoxication and dehydration. Long-term effects of alcohol consumption include changes in the metabolism of the liver and brain and alcoholism. Alcohol intoxication affects the brain, causing slurred speech, clumsiness, and delayed reflexes. Alcohol stimulates insulin production, which speeds up glucose metabolism and can result in low blood sugar, causing irritability and, possibly death for diabetics. Severe alcohol poisoning is almost always fatal. A 2014 World Health Organization report found that harmful alcohol consumption caused about 3.3 million deaths annually worldwide.