Well the fastest way, I reckon, would be to read them from a table rather than compute them.
Your requirements on integer accuracy from using a double representation means that C(60,30) is all but too big, being around 1e17, so that (assuming you want to have C(m,n) for all m up to some limit, and all n<=m), your table would only have around 1800 entries. As for filling the table in I think Pascal's triangle is the way to go.
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