Cook pasta about 2 minutes less than the package instructions. Drain, rinse and set aside.
Heat butter in a skillet over medium heat until browned (about 2 minutes) and add garlic and shallots. Cook until soft then add the chopped sage. Sauté for 30 seconds.
Add the wine, cinnamon, nutmeg, salt, pepper, and cayenne pepper and simmer until reduced by half (about 5 minutes).
Add the pumpkin puree and bacon and bring to a simmer.
Add the cream and bring back to a simmer while stirring.
Add the pasta and cook for 1-2 minutes. Remove from heat and serve garnished with fresh sage leaves and grated Parmesan cheese.
Notes
Make sure not to overcook your pasta or the dish will be mushy. Cook it slightly less than al dente as it will continue to cook when added to the sauce.
Cook the bacon extra crispy to ensure it is easily crumbled and doesn't get soggy in the dish.
Fresh grated parmesan is highly recommended as it melts into the sauce better.
Make it vegan by substituting olive oil for butter, coconut cream for heavy cream, and vegan cheese for Parmesan, as well as omitting the bacon.
If you use homemade pumpkin puree, strain it through a mesh sieve to squeeze out any excess liquid (it tends to be thinner than canned versions).