Costly surgical treatments aren’t always better for people with diabetes and stable heart disease, according to research presented at the American Diabetes Association’s 69th Scientific Sessions in New Orleans. A five-year study found that heart surgery saved no more lives in such people than intensive medical treatment, which consisted of both medication to control cardiac risk factors and therapy to help patients quit smoking, lose weight, and exercise regularly. However, higher-risk patients did benefit from prompt bypass surgery: They had fewer heart attacks and strokes than similar patients who didn’t have the operation. All of the study’s nearly 2,400 participants received both intensive medical therapy and a surgical recommendation—a doctor’s choice of either angioplasty (propping open an artery to improve blood flow) or bypass surgery (creating an alternate path for blood to flow around a blockage). Physicians tended to select higher-risk patients for bypass. Half of the participants had the recommended surgery right away; the rest initially received only medicine and counseling. The study did not compare bypass surgery with angioplasty. Researchers also assessed which diabetes medicines are best for heart patients: those that make insulin work better—like metformin, rosiglitazone (Avandia), or pioglitazone (Actos)—or insulin itself. They found that both glucose control strategies had a similar impact on survival and rates of heart attack and stroke.