Bring a large pot of salted water to a boil and cook the fettuccine until al dente. Reserve 1/2 cup of the pasta water, then drain the pasta and set it aside.

Heat 1 tablespoon of olive oil in a large skillet over medium heat. Add the diced pancetta and cook until it turns golden and crisp. Remove the pancetta with a slotted spoon and set it aside on a plate.

In the same skillet, add the remaining tablespoon of olive oil. Place the sage leaves in the oil and fry for 30 to 45 seconds until they become crisp. Remove the sage and set it aside with the pancetta.

Add the minced garlic to the skillet and cook for 30 seconds until fragrant. Stir in the pumpkin puree and heavy cream. Season with salt and pepper, then simmer for 3 to 4 minutes until the sauce thickens slightly.

Add the drained fettuccine to the sauce along with the reserved pasta water. Toss everything together until the pasta is evenly coated. Stir in the grated Parmesan cheese.

Divide the pasta among four plates. Top each serving with the crispy pancetta and fried sage leaves.