At 11 pounds and more than 5,000 pages, the printed output of the House health appropriations subcommittee makes the prodigious Tolstoy seem terse and laconic.

But like the complicated Russian novel, the real meaning and essence of the congressional subcommittee hearing record often reside somewhere between the lines.

In other words: What you see and wht you read on the official record do not necessarily reflect reality as Congress goes about deciding how to spend federal money.

It is that way in every congressional committee and it can be said for just about every dollar appropriated. But this corner of reality is about a relatively tiny piece of President Carter's fiscal 1981 budget.

The president is asking Congress to spend about $3.5 billion for the biomedical research activities of the National Institutes of Health. NIH will use part of that money on diabetes, a major American affliction.

Now go back to April 1, when the House appropriations subcommittee for Labor-HEW met in an unusual evening session to hear testimony on Carter's proposal for NIH.

The only member present was the chairman, Rep. William H. Natcher (D.Ky.), when it came time to hear Dr. Ronald Arky, a Harvard professor who was then president of the American Diabetes Association.

As is often his way, Natcher said "off the record" -- a signal for the stenographer to stop transcribing -- and asked Arky a simple question.

"Doctor, what is the major advance in diabetes research in the last three years?"

Arky answered straightforwardly: "The awareness of the public that diabetes is a major problem.That has come through research."

The question and the answer, in combination with a look between the lines, cast an interesting light on the massive federal expenditure for research into causes and cures for diabetes and other diseases.

According to NIH, Congress has given the organization $371.3 million in the last three years for its work on diabetes, one of the country's most crippling and costly illnesses.

Each year, citizen witnesses and scientists testify about new hopes for cures and relief for the 4.8 million or more diabetics in the country. Then they call for more research money.

Under this heavy pressure, Congress has responded with large doses of greenbacks. Ironically, the experts concede, in 50 years of research there has not been a major development comparable to the discovery of insulin around 1920.

Yet hope is reborn every spring at the time of the appropriations hearings on Capitol Hill. Promise is held high; excitement fills the committee rooms.

The numbers and statements appear in the printed record of Natcher's subcommittee, which is responsible for slightly more than one-third of the entire federal budget.

Members' decisions on how much to appropriate for diabetes, for example, or for cancer or heart disease research, will hinge in part on the voluminous hearing record.

Missing from the record is Arky's informal exchange with Natcher, a frank expression that seemed to be saying that not as much had been achieved with the $371.3 million from diabetes research as Congress intended.

For the record, Arky and other witnesses did not say that at all. They did not come close to suggesting that. Instead, they talked about the hopes and the advances, and the great need for more money.

The legislative process is so complex and the congressional workload so huge that not much reading can be done between the lines. There is rarely time for that.

A couple of years ago, Sen. H. jOhn Heinz III (R.Pa.) -- an early champion of intensified diabetes research -- paused long enough to wonder what good, if any, all those federal dollars were doing.

He asked the General Accounting Office to analyze spending on diabetes research, education and treatment. GAO auditors gave a preliminary report this week: No breakthroughs yet, no scandals, widespread agreement among medical people that NIH is on the right track, but that more research is needed.

But even within the army of citizen-advocates who march in support of more research attention for diabetes, there are critics and iconoclasts who have made themselves unpopular by raising questions.

The most outspoken may be Carl Stenzler, a retired clothing manufacturer from Elkins Park, Pa., a diabetic who chaired the Pennsylvania Committee on Diabetes between 1973 and 1975.

Stenzler asks questions and makes points about research that his brothers and sisters in the army of advocacy find offensive. When the diabetes money appeals were made on April 1, Stenzler's confreres avoided him like the plague.

After Stenzler testified, an angry woman from the Juvenile Diabetes Foundation said to him, "Your statistics are all wrong." Stenzler just shrugged it off.

His statistics, compiled from a variety of public and private sources suggest that the advocacy groups regularly overstate the number of victims as a way of demonstrating needs for more research.

"It is the process that concerns me," Stenzler said recently. "This is an awful way to do things. The appropriations are made on the basis of who makes the most noise. I am not against research. I just want to see reason applied to the decisions on spending."

Stenzler outlined many of his concerns during his testimony April 1. He urged Congress to reevaluate the way it hands out research money, require the researchers to justify their work more thoroughly, force them to establish clearer priorities.

Will Congress listen? Carl Stenzler's testimony covers six pages in the subcommittee hearing record. Almost all of the other 5,046 pages in four volumes related to health and research go the other way. They urge more money and raise few questions.